The Bathtub Birth by Sara Goldstein

This story appears in the newly-released book A Doula’s Journey: Into the World of Birth by Sara Goldstein:

After accompanying Etti to six out of seven births, our relationship was more than client/professional. We had become friends. I had attended her celebrations after her babies were born, met her extended family and attended births of her siblings.

Etti’s labors followed the same pattern. She labored at home for a few hours before calling me. I joined her in her home and a short time later we proceeded to her private doctor at the hospital.

While attempting to handle the one-minute long contractions, which came every two minutes during the last hour of her otherwise easy labor, she attempted to answer the questions asked upon arrival.

The intake was handled by the nurses. “How old are you? When was your last period? Do you or your husband smoke?” There were about twenty questions altogether, the answers to most of them were in the file she had brought with her.

Etti detested that part of her labor. She was trying to focus, trying to cope. However, this was policy. The information must be documented.

We spoke last time about changing hospitals and doctors but she said, once again, “But I really like Dr. Rubin*.” My heart sank. We were now on birth number eight and she still wasn’t aware that she could make different birth choices. Spreading the word is only as good as a woman’s decision-making abilities. We had discussed her options but changing the familiarity of a particular doctor and hospital is unnerving for many women. They also may not realize how much better the experience can be.

So, one Monday morning when the phone rang at 7:00 and I heard Etti’s voice, with a bit of sadness. I thought, “What a pleasure being with her despite the mire she is stuck in.” Arriving at her house, I found her in the bath. I dropped lavender and orange aromatherapy oil to surround her with the fragrances she enjoyed. After placing the cassette into the recorder, my hands started the “double-hip squeeze”, the only physical help that kept her from asking for drugs. I leaned over her as my hands found the spots on either side of the meatiest part of her hips, I pressed inwards. My knees were slightly bent to relieve pressure on my back. Her husband was busy scurrying the children off to school and arranging the babysitter for the eighteen-month old.

While with Etti, we continued our slow-paced breathing together during contractions while catching up on news in-between. This was still the early phase of labor. When she was at a more advanced stage of labor she preferred quiet. As I refilled her drinking bottle, she removed herself from the bath to relieve herself.

By 9:30, Ari, at Etti’s request, called Dr. Rubin letting him know that they would be heading to the hospital in a few hours. “No problem”, he responded, “I am already here working in the department.”

As Etti’s contractions finally were close enough to really consider leaving for the hospital, she asked, “Can we wait a bit longer?” They were four minutes apart but there was no traffic now and the hospital was fifteen minutes away. I never see a reason to arrive too early; however Etti’s face showed signs of intensity which weren’t there earlier. I reminded her how quickly the last hour goes, jumping from five centimeters dilation to ten. “Yes,” she responded, “but I hate the hospital; the intake, the commotion, them telling me what to do.”

I remained quiet, finding it difficult to disagree with her pleas.

“Okay, let’s wait a few more minutes,” was all I could say.

Ten minutes later, she quietly murmured, “What would happen if the baby suddenly descended and I have to push? Is there anything you need to deliver the baby?”

Ah-ha. Now I got it. Subconsciously or not, Etti wanted to birth this baby at home. “Etti, I am not a medical person. I have no equipment with me—nothing! Even if I did, this is not within my scope of practice. I am a doula, not a midwife.”

Inside I was in turmoil. How could I allow this to unfold before my eyes? My heart whispered, “Let her have the birth she deserves!”

My brain said, “I am not a qualified home birth midwife. What could I do if there are any complications that a midwife is trained to handle? We have to go now!”

“Ari, please call an ambulance,” I said.

Ari, from outside the cramped bathroom calmly said, “Okay.”

Etti answered, “Not yet! It isn’t time.”

The conflict raged within me. She obviously wanted to stay home.

“Etti, please call a homebirth midwife. It may not be too late.”

I knew good and well that there were none who lived in the city. The closest one lived a twenty-minute drive away. But maybe there was a midwife in the city. One never knows.

“Great idea,” I heard from outside the bathroom door. “Can you give me a couple of numbers?”

While I passed Ari numbers, praying someone was in the city, Etti stated in a quiet but certain way, “My waters are opening. I am sure they broke.”

“Ari, you have to call an ambulance!”

“No”, said Etti.”

This is the stage where Etti began to tense and by now, usually in the hospital, her doctor asked her to get on the bed in the standard position.

I had tears of joys in my eyes as I watched her, in a standing position, knees a bit bent, as she bore down taking charge of her body and birthing the way she wanted. I had to admit I was proud of her. I pushed away the fear that we were being irresponsible. There was no time for self-chastisement.

“Jane is on the way. She was interviewing a client in the city”, exclaimed Ari. “She said she doesn’t want to come because she doesn’t have her birth kit with her.”

I shouted back, “Tell her I have no supplies and I am a doula. She has nothing, but she is a midwife!”

“She wanted to know if there are any medical issues,” Ari continued to shout.

“None,” is all I answered; there was too much going on right now. I kept this conversation short and sweet.

Right or not, Etti was not moving and they weren’t calling an ambulance. I breathed a sigh of relief knowing Jane was coming, even though I was well aware that there were only minutes before this baby would be born and she may not make it.

“Etti, blow for a few minutes to give Jane a chance to get here.” She quietly shook her head “no.” I saw I didn’t even have time to put on gloves. (After taking two courses to learn how to handle an emergency delivery, I was told to carry a pair “just in case”). After two pushes, a pink, baby boy slipped into my waiting hands. Etti was in a state of euphoria.

“I don’t believe I am standing in my bathtub holding my new child,” she exclaimed with joy. I gently placed Etti’s son into her arms, keeping the baby at the level of the placenta. Ari passed me a warm towel from the dryer, a precaution I had learned. Rubbing his little back to dry him off and to make sure he continued a good cry, I didn’t truly relax until I saw Jane walk through the bathroom door.

Jane arrived in time to attend to the cord. “I am so glad you could come.” After helping Etti wash off, which was easy to do in the bath tub, we guided her to her bed, keeping her newborn wrapped in warm towels. Etti breastfed her son while Jane attended to the placenta. Ari brought Jane a container to save the placenta in. The eighteen-year old babysitter returned with the eighteen month old, putting on a happily surprised face when she heard the good news and saw the new baby.

Jane made sure the uterus was contracting normally. Then she stepped outside the bedroom to give the parents their time for bonding. I gave Jane an embrace with a big “thank-you” for running to meet us. Smiling back she replied, “I am all for choice but can you just plan it a bit earlier next time?”

9 comments

Wow, made me cry since I am days away from this moment G-d willing… I too have made a different decision with this one. But it’s opposite to what most people do. I’ve had 3 natural births and as my due date was nearing, I noticed I was getting more and more anxious about doing it again. Not that I’ve had bad labors, I did it all right, did the breathing, had a midwife… but the intensity and hard work just scares me.

When my friends told me it didn’t have to be this way, I let the thought of an epidural enter my mind. I calmed down sooo much. I told my midwife and my husband that this time, things are going to be different. I can do the labor, but when it gets close to the end, I don’t want to do it anymore. Yes, I am aware of the side affects, aware of everything that can happen — but this time I just want to see my baby, whole and healthy and I don’t really care how I get there. I’ll let you know how it goes B’ezras Hashem at the right time!

I am glad it had a happy ending. It could have easily turned into a tragedy Chas V’sholom. The doula knew how risky this was but her client made the choices. Obviously, the sane thing would have been to convince the woman at an earlier point in time to see a homebirth midwife so that this could have happened with all safety precautions in place. I am sure that this woman would be open to it after this experience.

Could have, but not “could have easily.” A multipara with a quick labor has a very small chance of something going wrong. Especially with a trained midwife arriving any second in case of problems, and EMS arriving (had the midwife not been available).

I think everyone involved here knew that it was not a responsible decision, and would have done it differently with more forethought.

I think the point of this story was to share that other choices are possible, not to suggest having an unplanned homebirth! Had this mom realized that homebirth was a real option, she presumably would have hired the midwife to begin with. Hopefully this will save other mothers from making subconscious decisions when a conscious, responsible one is an option.

(I’m sure you’re aware that some mothers end up having their babies on the way to the hospital. As a decision it is a lousy one, but things happen, and most of the time those births go perfectly – under far worse circumstances than a home with a doula present and a midwife on her way.)

I gave birth to my fourth child alone at home while the children were sleeping and my husband had run out to get a friend to babysit so we could get to the hospital. In seven minutes I went from being in labour to needing to push. I called the ambulance who stayed on the line with me and assured me I could start pushing since the ambulance was already dispatched. I don’t think he thought I’d give birth before they arrived…. Baruch HaShem it was amazing but it wasn’t until later that we realised how many miracles occurred for that to happen….. But it was the most amazing experience of my life.

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